Surgery for Tetralogy of Fallot in Adults: Early Outcomes

Abstract

ObjectiveTo study the in-hospital outcome of adult patients who had undergone surgical repair for Tetralogy of Fallot.MethodsA retrospective descriptive study was conducted at the Punjab Institute of Cardiology searching the hospital records. All those adult patients who had undergone repair for Tetralogy of Fallot from January 2012 to December 2014 were included in the study. All the patients were operated by the same surgical team. Patients who underwent primary repair as well as those with previous palliative procedures were included in the study. Thirty days outcome was studied by recording variables from the database. Data was analysed using Statistical Package for Social Sciences version 16.ResultsA total of 80 patients was included in the study, in which there were 48 (60%) male patients and 32 (40%) female patients. Mean age was 21±0.21 years. Those with previous palliation were 15 (18.75%). The associated problems observed were: atrial septal defect 27 (33.75%), right aortic arch 30 (37.5%), patent ductus arteriosus 6 (7.5%) and double outlet right ventricle 3 (3.75%). In-hospital mortality recorded was 7 (8%). Postoperative complications encountered were low cardiac output syndrome 9 (11.25%), pleural effusion requiring tapping 3 (3.75%), reoperation for bleeding 3 (3.8%), pulmonary regurgitation (moderate to severe) 20 (25%) which occurred in the transannular patch group only and atrial arrhythmia 4 (5%).ConclusionA large number of adult patients are still operated for tetralogy of Fallot in Pakistan. With increasing experience in the technique the mortality and morbidity is comparable to international literature.

Tetralogy of Fallot repair in patients presenting after Infancy: A single surgeon experience

“…9 Khan et al reported 8.0% mortality rate in late TOF patients. 13 In our study, the operative mortality was only 1.3% which was very low as compared to these studies. Wu et al reported the results of 212 patients who underwent TOF repair having age 1.5 year to 37 years.…”

Factors associated with perioperative mortality in children and adolescents operated for tetralogy of Fallot: A sub‐Saharan experience

“…In our series, 8 of 62 (12.9%) patients died during the perioperative period. This is higher than reported in many studies from the developed world, which report on younger patient populations and have more advanced perioperative facilities. As a surgical intervention for CHDs including TOF is not readily available in most sub‐Saharan countries, few studies exist against which we can compare our results.…”

The Importance of the Proper Definition of Adulthood: What is and What is Not Included in a Scientific Publication

“…For instance, transannular patches are required more often in children than in adults, due to the more favorable anatomy encountered in adulthood [2] . In table 1, Khan et al [1] also showed a significant influence of age on the frequency in both right ventricular outflow tract and transannular patches.…”

“…Khan et al. [1] reported 25% of moderate/severe postoperative pulmonary regurgitation in their study. In this context, how did they evaluate these patients?…”

“…We have read with great interest the study by Khan et al [1] : “Surgery for Tetralogy of Fallot in Adults: Early Outcomes”, published in the Brazilian Journal of Cardiovascular Surgery, volume 31, issue 4, pages 300-3.…”